Active NPI
The Sports Rehabilitation Center
- Physical Therapy Clinic/Center
- Atlanta, GA
National Provider Identifier
1154409381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Clinic/Center
- Legal business name
- THE SPORTS REHABILITATION CENTER
- Practice address
- 555 10TH Street NW
Atlanta, GA 30318-5713 - Phone
- (404) 477-8888
- Fax
- (404) 477-8889
- NPI assigned
- Nov 2, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Destiny Carr
- Title
- Office Manager
- Phone
- (404) 477-8888
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Clinic/Center | 261QP2000X | Primary |
Addresses
Primary practice location
555 10TH Street NW
Atlanta, GA 30318-5713
Mailing address
555 10TH Street NW
Atlanta, GA 30318-5713
Phone (404) 477-8888
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040127000743 | GA | Part B Supplier - Clinic/Group Practice | 0648177485 |
Receives reassigned benefits from 23 practitioners Practice locations: Atlanta, GA |
National Provider Directory
National Provider DirectoryLocations
555 10th St NW
Atlanta, GA 30318
Phone (404) 477-8888
Practitioners & affiliated clinicians
Practitioners 34
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162425600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1362960000000",
"number": "1154409381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "555 10TH STREET NW",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303185713",
"telephone_number": "404-477-8888",
"fax_number": "404-477-8889"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "555 10TH STREET NW",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303185713",
"telephone_number": "404-477-8888",
"fax_number": "404-477-8889"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "THE SPORTS REHABILITATION CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-02",
"last_updated": "2013-03-11",
"status": "A",
"authorized_official_last_name": "CARR",
"authorized_official_first_name": "DESTINY",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "404-477-8888",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "261QP2000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Physical Therapy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
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- The Southeast Permanente Medical Group
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- The Springs Chiropractic Health Centre
- The Surgical Suite, Inc
- The Szikman Dental Group, P.C.
- The Tayler-Karringtion Healthcare Group, L.L.C.
- The Tender Touch
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.